How much rates vary
Facilitymedian $776 · 10th to 90th $398 to $6,761Professionalmedian $1,230 · 10th to 90th $759 to $1,995
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $7,943.28 | Facility | None | $758.58 | $758.58 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | None | $758.58 | $758.58 | $891.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $758.58 Median $1,348.96 Typical High $2,137.96 | Professional | None | $758.58 | $1,348.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,513.56 | Professional | None | $776.25 | $794.33 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,174.90 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,202.26 | Facility | None | $724.44 | $724.44 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,023.29 | Professional | None | $724.44 | $912.01 | $1,023.29 |
Oscar Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $933.25 | Professional | None | $891.25 | $891.25 | $933.25 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,380.38 | Professional | None | $645.65 | $776.25 | $1,380.38 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $602.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $457.09 Typical High $562.34 | Professional | 51 · Multiple procedures | $363.08 | $457.09 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $186.21 Typical High $239.88 | Professional | 80 · Assistant surgeon | $144.54 | $186.21 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $128.82 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $100.00 | $128.82 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $128.82 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $128.82 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $128.82 Typical High $169.82 | Professional | AS · PA/NP assist | $100.00 | $128.82 | $169.82 |
Where North Carolina sits
The same service costs 12.3 times more in Maine than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $16,849MD $1,375
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.